Antifungal treatment of allograft tissue for cardiac surgery

Amphotericin B, nystatin, clotrimazole and candicidin have been compared as antifungal agents in a sterilizing mixture for allograft tissues used in cardiac surgery. Candicidin was shown to be too toxic, and clotrimazole has since been restricted to topical application. Nystatin and amphotericin B are equally effective in controlling fungal contamination when compared in terms of effectiveness, cytotoxicity and cost. Early onset fungal endocarditis associated with allograft tissue treated in this way can be reduced to a minimum by an appreciation of these results and an application of rigorous screening procedures for fungi.